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Commemorative Marriage Certificate Application Form by gI9lrI

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									        Commemorative Marriage Certificate Application Form
1. Details of Person applying for the Certificate

Name

Address



Postcode                                             Contact Telephone No.

Email

Address where Certificate should be sent, if different from above




2.      Marriage Certificate design you would like (please indicate number in each box)

        Rings          Rose          Ornate


3.       Information to be entered on Marriage Certificate

Name of Bride and Groom as they should appear on Certificate (Please write clearly in block capitals)
Groom

Bride


Date of Marriage:

Place of Marriage:

Marriage Ceremony Conducted by:




4.       Payment
I would like to order …………… Commemorative Marriage Certificates @ £9.00 + £1.00 postage and packing
each. I enclose a cheque/Postal Order made out to Cambridgeshire County Council for £ ……………………

Or debit my Visa/Switch Card No

Expiry Date                     Issue No.            Security No.

Name as it appears on card
Or I am applying in person at a Cambridgeshire Registration Office with £…………… in cash
Postal applications should be sent to: The Registration Office, 74 Market Street, Ely, Cambs, CB7 4LS

								
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